<field:nianling itemname="受助年龄" autofield="1" notsend="0" type="int" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:nianling>
<field:quyu itemname="区域（省市）" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:quyu>
<field:shenqingshijian itemname="申请时间" autofield="1" notsend="0" type="datetime" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:shenqingshijian>
<field:zhuangtai itemname="状态" autofield="1" notsend="0" type="radio" isnull="true" islist="1" default="已申请,审核中,审核未通过,材料补充中,待筛查,审核通过,救助中,救助完成,申请关闭"  maxlength="250" page="">
</field:zhuangtai>
<field:zizhujine itemname="爱尔资助金额（万元）" autofield="1" notsend="0" type="float" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:zizhujine>
<field:zizhuleixing itemname="资助类型" autofield="1" notsend="0" type="radio" isnull="true" islist="1" default="手术,康复,手术+康复,矫形手术"  maxlength="250" page="">
</field:zizhuleixing>
<field:xingbie itemname="性别" autofield="1" notsend="0" type="radio" isnull="true" islist="1" default="男,女"  maxlength="250" page="">
</field:xingbie>
<field:chushengriqi itemname="出生日期" autofield="1" notsend="0" type="datetime" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:chushengriqi>
<field:minzu itemname="确诊年龄" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:minzu>
<field:huanerno itemname="患儿身份证号" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:huanerno>
<field:hujizhuzhi itemname="户籍住址" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:hujizhuzhi>
<field:jianhurenname itemname="监护人姓名" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jianhurenname>
<field:guanxi itemname="关系" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:guanxi>
<field:jianhurenlianxi itemname="监护人联系方式1" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jianhurenlianxi>
<field:jianhurenlianxi2 itemname="监护人联系方式2" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jianhurenlianxi2>
<field:jianhurenshno itemname="监护人身份证号" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jianhurenshno>
<field:jinjirenname1 itemname="紧急联系人1" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jinjirenname1>
<field:jinjiren1guanxi itemname="紧急人1-关系" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jinjiren1guanxi>
<field:jinjiren1lianxi itemname="紧急人1-联系方式" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jinjiren1lianxi>
<field:jinjiren2 itemname="紧急联系人2" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jinjiren2>
<field:jinji2guanxi itemname="紧急人2-关系" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jinji2guanxi>
<field:jinji2lianxi itemname="紧急人2-联系方式" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jinji2lianxi>
<field:shenqingshuoming itemname="患儿监护人求助申请" autofield="1" notsend="0" type="htmltext" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:shenqingshuoming>
<field:juweihui itemname="家庭所在地/村（居）委会" autofield="1" notsend="0" type="htmltext" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:juweihui>
<field:xiangzhen itemname="家庭所在地乡镇/街道办事处" autofield="1" notsend="0" type="htmltext" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:xiangzhen>
<field:cengyiyuan1 itemname="曾治疗医院1" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:cengyiyuan1>
<field:zhiliao1 itemname="治疗日期1" autofield="1" notsend="0" type="datetime" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:zhiliao1>
<field:cengyiyuan2 itemname="曾治疗医院2" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:cengyiyuan2>
<field:zhiliao2 itemname="治疗日期2" autofield="1" notsend="0" type="datetime" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:zhiliao2>
<field:jigoushijian itemname="机构康复累计时间" autofield="1" notsend="0" type="datetime" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jigoushijian>
<field:jianshu itemname="其他疾病简述" autofield="1" notsend="0" type="htmltext" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jianshu>
<field:jianhurenqianzi itemname="监护人签字" autofield="1" notsend="0" type="text" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:jianhurenqianzi>
<field:yyyj itemname="定点医疗机构审核意见" autofield="1" notsend="0" type="htmltext" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:yyyj>
<field:aieryijian itemname="爱尔意见" autofield="1" notsend="0" type="htmltext" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:aieryijian>
<field:beizhu itemname="标识后台提交过一次的数据" autofield="1" notsend="0" type="htmltext" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:beizhu>
<field:liyou itemname="康复医师意见" autofield="1" notsend="0" type="htmltext" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:liyou>
<field:num itemname="编号" autofield="1" notsend="0" type="int" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:num>
<field:hrimg itemname="患儿照片" autofield="1" notsend="0" type="imgfile" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:hrimg>
<field:jhrsqz1 itemname="居/村委会家庭情况真实性核查意见" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:jhrsqz1>
<field:jhrsfz2 itemname="法定监护人身份证(背面) " autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:jhrsfz2>
<field:jhrhkzy itemname="法定监护人户口本(主页)" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:jhrhkzy>
<field:sqly itemname="申请理由（200字）" autofield="1" notsend="0" type="htmltext" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sqly>
<field:tijiao itemname="提交状态" autofield="1" notsend="0" type="int" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:tijiao>
<field:test itemname="就诊医院" autofield="1" notsend="0" type="radio" isnull="true" islist="0" default="北京中医药大学东直门医院,北京中日友好医院,首都儿科研究所附属儿童医院,新疆医科大学附属第二人民医院,新疆生产建设兵团医院,喀什地区第二人民医院,西藏自治区第二人民医院,林芝市人民医院,广州市红十字会医院"  maxlength="250" page="">
</field:test>
<field:shztime itemname="审核中时间" autofield="1" notsend="0" type="datetime" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:shztime>
<field:shjgtime itemname="审核结果时间" autofield="1" notsend="0" type="datetime" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:shjgtime>
<field:zzztime itemname="资助中时间" autofield="1" notsend="0" type="datetime" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:zzztime>
<field:yzztime itemname="已资助时间" autofield="1" notsend="0" type="datetime" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:yzztime>
<field:clbctime itemname="材料补充中时间" autofield="1" notsend="0" type="datetime" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:clbctime>
<field:dsctime itemname="待筛查" autofield="1" notsend="0" type="datetime" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:dsctime>
<field:shoushufei itemname="手术费用" autofield="1" notsend="0" type="float" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:shoushufei>
<field:kangfufei itemname="康复费用" autofield="1" notsend="0" type="float" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:kangfufei>
<field:ercishoushufei itemname="二次手术费" autofield="1" notsend="0" type="float" isnull="true" islist="1" default=""  maxlength="250" page="">
</field:ercishoushufei>
<field:sn_xing_num itemname="星量" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_xing_num>
<field:sn_2_name itemname="患儿2姓名" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_2_name>
<field:sn_2_chusheng itemname="患儿2出生年月" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_2_chusheng>
<field:sn_2_sex itemname="患儿2性  别" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_2_sex>
<field:sn_2_age itemname="患儿2确诊年龄" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_2_age>
<field:sn_2_shenfen itemname="患儿2身份证号" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_2_shenfen>
<field:sn_2_canji itemname="患儿2是否办理残疾证" autofield="1" notsend="0" type="radio" isnull="true" islist="0" default="是,否"  maxlength="250" page="">
</field:sn_2_canji>
<field:sn_canji itemname="是否办理残疾证" autofield="1" notsend="0" type="radio" isnull="true" islist="0" default="是,否"  maxlength="250" page="">
</field:sn_canji>
<field:jinjiren1lianxi2 itemname="紧急人1-联系方式2" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:jinjiren1lianxi2>
<field:jinji2lianxi2 itemname="紧急人2-联系方式2" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:jinji2lianxi2>
<field:sn_kangfu_name itemname="康复姓名" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_kangfu_name>
<field:sn_kangfu_name2 itemname="康复姓名2" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_kangfu_name2>
<field:cengyiyuan3 itemname="曾康复医院" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:cengyiyuan3>
<field:zhiliao3 itemname="康复日期3" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:zhiliao3>
<field:zizhuriqi itemname="资助日期" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:zizhuriqi>

<field:kangfujigou1 itemname="康复机构" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kangfujigou1>

<field:kangfu1shijian itemname="自1" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kangfu1shijian>

<field:kfjs1 itemname="至1" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kfjs1>

<field:kangfujigou2 itemname="康复机构2" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kangfujigou2>

<field:kangfushijian2 itemname="自2" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kangfushijian2>

<field:kfjs2 itemname="至2" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kfjs2>

<field:kangfujigou3 itemname="曾康复机构3" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kangfujigou3>

<field:kangfushijian3 itemname="自3" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kangfushijian3>

<field:kfjs3 itemname="至3" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kfjs3>

<field:sn_sfzm itemname="患儿身份证明" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_sfzm>

<field:sn_jhrsfzm itemname="监护人任意一方身份证明(照片)" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_jhrsfzm>

<field:sn_cjzsy itemname="患儿残疾证首页" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_cjzsy>

<field:sn_qzzm itemname="患儿确诊证明：" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_qzzm>

<field:sn_hkbsy itemname="户口本首页" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_hkbsy>

<field:sn_sfzm2 itemname="患儿2身份证明" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_sfzm2>

<field:sn_cjzsy2 itemname="患儿2残疾证" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_cjzsy2>

<field:sn_qzzm2 itemname="患儿2确诊证明" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_qzzm2>

<field:sn_hkbsy2 itemname="患儿2户口本首页" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_hkbsy2>

<field:sn_sfzmb2 itemname="患儿2身份证明(背面)" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_sfzmb2>

<field:sn_sfzmb itemname="患儿身份证明(背面)" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_sfzmb>

<field:sn_jhrsfzmb itemname="监护人任意一方身份证明(背面)(照片)" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_jhrsfzmb>

<field:sn_jhrhkb itemname="法定监护人户口本页面信息" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_jhrhkb>

<field:kangfujigou12 itemname="患儿2曾康复机构" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kangfujigou12>

<field:kangfu1shijian2 itemname="患儿2自" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kangfu1shijian2>

<field:kfjs12 itemname="患儿2至" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kfjs12>

<field:kangfujigou22 itemname="患儿2曾康复机构2" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kangfujigou22>

<field:kangfushijian22 itemname="患儿2自2" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kangfushijian22>

<field:kfjs22 itemname="患儿2至2" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:kfjs22>

<field:jianshu2 itemname="患儿2救助申请说明" autofield="1" notsend="0" type="text" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:jianshu2>

<field:sn_two_star_family_img itemname="孤独症双星家庭照片" autofield="1" notsend="0" type="imgfile" isnull="true" islist="0" default=""  maxlength="250" page="">
</field:sn_two_star_family_img>
